[Question #2671] Hiv std risks

44 months ago
Hello doctors would you please asses my risk and situation.. to start I'd like to mention that i had a negative hiv test in january since then i have not had unprotected sex with anybody as I tend to be somewhat obsessive about contracting stis, hiv specifically. I have protected sex with one woman only who tested negative in february, however we are not a couple so I do not know what she does other than with me. These are the situations that worry me

1.) this to me is the most worrisome situation. I gt a bit drunk and had an encounter with a CSW, it did not involve sex of any kind she just masturbated me but in the act she decided to slightly insert a finger in my anus...this was after a batchelor party so she had been with another man before me...a few days later i began to get real itchy around my anus and it lasted for about a week and i got very anxious and kind of obsessed over it it eventually subsided.can someone elses semen or her vaginal fluids infect me?

2.) i received unprotected blowjobs from 4 separate women one of them being a stripper the other 3 females i know...i know profession has nothing to do with it but in this case i knew the girls and their sexual lifestyle is completely different from a strippers...am i at risk of hiv from receiving these blowjobs? I know for a fact i did not contract an std..

3.) this is the most recent i have some skin tags in my lower stomach close to my belly button, they look like tiny hpv warts i think or just small skin tags...i was picking at them and eventually hurt 3 of them one i took of an bled somewhat...later that day i received a happy ending massage by a fully nude woman...she climbed on top of me with her behind facing me,her vagina was directly on my belly button area, fully nude...she mentioned she was going to start or was out of her period..am i at risk if secretions or blood came in contact with these injured sores?

3)two weeks after a protected sexual encounter, i developed a mild infection which caused fever and drenching night sweats, which got me worried because i have never developed typical ars symptoms.

4)yesterday i picked up a girl at a bar and had a one night stand, she gave me unprotected oral and we had protected sex for about 10 min, i kept checking the condom and it seemed fine, i ejaculated in it and it seemed in tact, i am worried because i inserted my fingers in her with a cut and also because right after i grabbed my own penis and i am afraid i got her fluids after that i quickly out on a hefty amount of sanitizer.
 
Do you consider any of the above situations a probability of contracting hiv or should i let it go?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question and for your confidence in our services.

My first thought is to congratulate you on having only very safe sex during these encounters. You are at zero risk for some STDs, including HIV, and only modest risk for a few. I disagree somewhat with your apparent distinction between strippers and sex workers: certainly not all strippers accept payment for sex, but there is a lot of overlap between them.

First, HIV:  it is never transmitted by hand-genital contact, fingering, kissing, or (probably) oral sex. There has never been a proved case of HIV transmission mouth to penis. Superficial wounds like your picked-at skin tags are rarely if ever the source of HIV. On top of all that, it is statistically unlikely any of your partners had HIV (whether or not they were strippers, sex workers, or both). So no worries for HIV and no need for testing unless you decide to do it strictly for reassurance. 

 Second, your skin tags sound exactly like that, ie  not warts. Genital warts almost always show up at sites of most direct sexual contact, like the penis, not the lower abdomen. Warts also generally take 2-12 months to become apparent.

Your anal symptoms might be the result of physical irritation from the fingering, or entirely unrelated to it. That even was risk free for any STD.

The main activity that carried any risk at all was receiving oral sex. The three main STDs from penile exposure to partners mouths are gonorrhea (very unlikely, since it almost always causes prominent symptoms within a few day); herpes due to HSV1, which also would usually cause symptoms; and nongonococcal urethritis (NGU), often due to normal oral bacteria and generally harmless. Very low risk for chlamydia, maybe slight risk for warts. There is always a possibility of syphilis, but heterosexually acquired syphilis currently is quite uncommon.

All in all, I don't recommend testing unless you develop symptoms. However, if you would like the additional reassurance, standard STD testing would make sense:  a urine test for gonorrhea and chlamydia (valid any time) and blood tests for syphilis and HIV 6 weeks after the last oral sex exposure. But I consider all these optional. If you do them, say relaxed in the meantime:  you can expect negative results.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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43 months ago
Thank you for your prompt response Dr. I feel sonmuch better and i have only one question to ask, taking into consideration all that i have told you, which is completely honest and i have described almost with preciseness, would you say that my chances of having contracted hiv were basically nonexistent or irrational to be thinking about having contracted it
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Nobody can say receiving oral sex is zero risk for HIV, so "nonexistant risk" goes a little to far. However, I would support "nonexistant risk for all practical purposes", since there has never been a proved case of HIV transmission mouth to penis, or by hand-genital contact. Other STDs are somewhat more likely, however, and with four separate unprotected oral sex exposures, urine testing for gonorrhea and chlamydia and a blood test for syphilis makes sense. If you do those, you may as well have an HIV test as well. As I implied above, some anxious persons will continue to worry and are more reassured by having a negative test even when the risk is virtually zero.---
43 months ago
Sorry doc, I did not completely understand, but given the circumstances, do you think i can expect negative hiv results?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Having re-read my reply, I can't see what is unclear. But yes, you definitely can expect negative test results. Please re-read my replies above (all of them); I think you will understand why there is no cause for worry.

That concludes the 2 follow-up comments and replies included with each question, and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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